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Risk factors of visceral leishmaniasis: a case control study in north-western Ethiopia

机译：内脏利什曼病的危险因素：埃塞俄比亚西北部的病例对照研究

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Background Visceral leishmaniasis (VL, also called `?kala-azar?), is a life threatening neglected tropical infectious disease which mainly affects the poorest of the poor. VL is prevalent in Ethiopia particularly in the northwest of the country. Understanding the risk factors of VL infection helps in its prevention and control. The aim of the present study was to identify the factors associated with VL. Methods A case?control study was carried out during the period of January-July 2013 in northwest Ethiopia. Cases and controls were diagnosed using clinical presentation, the rk39 rapid diagnostic test and Direct Agglutination Test (DAT). A total of 283 (84.8% males versus 15.2% females) participants were interviewed. 90 cases and 193 controls were involved, matched by age, sex and geographical location with a ratio of 1:2 (case: controls). Univariate and backward multivariate conditional logistic regression were used to identify risk factors of VL. Results Elevated odds of VL was associated with goat ownership (OR?=?6.4; 95%: confidence interval [Cl]: 1.5-28.4), living in houses with cracked wall (OR?=?6.4; 95% Cl: 1.6-25.6), increased family size (OR?=?1.3; 95% Cl: 1.0-1.8) and the number of days spent in the farm field (OR?=?1.1; 95% Cl: 1.0-1.2). However, daily individual activities around the home and farm fields, mainly sleeping on a bed (OR?=?0.2; 95%: Cl 0.03-0.9), sleeping outside the house under a bed net (OR?=?0.1; 95% Cl: 0.02-0.36)] and smoking plant parts in the house during the night time (OR?=?0.1; 95% Cl: 0.01-0.6) were associated with decreased odds of being VL case. Conclusion Our findings showed that use of bed net and smoke could be helpful for the prevention of VL in the area particularly among individuals who spend most of their time in the farm. VL control effort could be focused on improving housing conditions, such as sealing cracks and crevices inside and outside houses. Further research is warranted to elucidate the role of goats in the transmission of L. donovani, assess the impact of bed nets and the role of the traditional practice of smoking plants.
机译：背景内脏利什曼病（VL，又称“黑热病”）是一种威胁生命的被忽视的热带传染病，主要影响最穷的人。 VL在埃塞俄比亚非常普遍，尤其是在该国西北部。了解VL感染的危险因素有助于其预防和控制。本研究的目的是确定与VL相关的因素。方法于2013年1月至7月在埃塞俄比亚西北部进行病例对照研究。使用临床表现，rk39快速诊断测试和直接凝集测试（DAT）对病例和对照进行诊断。总共采访了283名参与者（男性为84.8％，女性为15.2％）。涉及90例和193名对照，按年龄，性别和地理位置匹配，比例为1：2（病例：对照）。采用单因素和后向多元条件logistic回归确定VL的危险因素。结果VL几率升高与山羊所有权（OR？=？6.4; 95％：置信区间[Cl]：1.5-28.4），居住在墙体开裂的房屋中（OR？=？6.4; 95％Cl：1.6-）相关。 25.6），增加了家庭规模（OR？=？1.3; 95％Cl：1.0-1.8）和在农田上度过的天数（OR？=？1.1; 95％Cl：1.0-1.2）。但是，家庭和农田周围的日常个人活动，主要是睡在床上（OR？=？0.2; 95％：Cl 0.03-0.9），睡在屋外床底下（OR？=？0.1; 95％）。 （Cl：0.02-0.36）]和夜间在屋内吸烟的植物部位（OR≥0.1，95％Cl：0.01-0.6）与VL病例的几率降低有关。结论我们的研究结果表明，使用蚊帐和烟具可能有助于预防该地区的VL，尤其是在农场中花费大部分时间的个体中。 VL控制工作可以集中在改善住房条件上，例如密封房屋内外的裂缝和缝隙。有必要进行进一步的研究来阐明山羊在多诺氏乳杆菌传播中的作用，评估蚊帐的影响以及传统吸烟植物的作用。

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